Empowering YOU to be in control

Posts tagged ‘cystocele’

Gehrung Pessary:
The Gehrung pessaries are available with or without support knob in Milex, please note that Bioteque no longer supply the gehrun with knob into the UK.

The Gehrung is suitable for women presenting a cystocele and/or rectocele. They are also very effective treating procidentia where the uterus tends to herniate when other pessaries are used.

Fitting the Gehrung: If being fitted using the one with knob support, this gehrung should be fitted with a full bladder then you will be asked to empty the bladder post fitting. This ensures the knob is positioned properly and you can empty your bladder properly. The one without the knob, it isn’t necessary to fit with a full bladder, however the patient must be able to empty the bladder fully when the gehrung is inserted.
I would suggest you irriagate the vagine prior to fitting, this removes any loose membrane and excess secretions, which could potentially get trapped between the vagina and pessary and cause an unpleasant smell later on.

Please be aware that the gehrung is one of the most difficult pessaries to fit and should only be fitted and removed by your medical professional trained in pessary fitting.

Those with endometriosis, this may not be suitable for you and should be discussed with your doctor.

The gehrung is made from medical grade silicone and the arch can be manipulated to support the rectocele.

Are you a medical professional and would like to know more about our educational program on pessaries. Please get in touch via www.candgmedicare.com

ABSTRACT
Objective To compare the outcome of pregnancy in cohorts of women with singleton pregnancy and history of preterm birth and sonographic short cervix managed with different treatment protocols, namely cerclage, vaginal progesterone or cervical pessary.Methods

This was a comparison of three management protocols for women with singleton pregnancy and a high risk of preterm birth because of a prior spontaneous preterm birth before 34 weeks and a shortened cervical length detected by transvaginal ultrasound. The study included 142 women who were initially treated with cerclage (USA), 59 with vaginal progesterone (UK) and 42 with cervical pessary (Spain). Perinatal outcomes were compared between the three cohorts.Results

There were no statistically significant differences in perinatal losses, neonatal morbidity and preterm births among the three groups, apart from a higher rate of preterm birth before 34 weeks’ gestation after treatment with vaginal progesterone in comparison with treatment with cervical pessary (32% vs 12%; relative risk (RR)=2.70; 95% CI, 1.10–6.67). When only the
subgroups of women with cervical length <25 mm, irrespective of gestational age, were compared, the difference between these two cohorts was not statistically significant (RR=2.21; 95% CI, 0.83–5.89).

Conclusion

Cerclage, vaginal progesterone and pessary appear to have similar effectiveness asmanagement strategies
in women with singleton pregnancy, previous spontaneous preterm birth and short cervix. Direct randomized comparisons of these strategies, or combinations thereof, are needed to determine optimal management.

It’s flu season; you’re hacking and hacking until you feel like your bottom end is going to blow out. And it just might be. if you’re like me you start to ramp up the germ-phoebe aspect of your personality around this time of year. We all start paying more attention to washing our hands, get nervous about grabbing the door at stores we shop at, walk the other way when we hear someone coughing. No one wants to get the flu. Yet despite the extra protective measures we take, we somehow manage to contract it. The majority of us are exposed to hundreds of germ infested surfaces every day; there’s just no way to get around it beyond wrapping ourselves in one of those protective bubbles. Not a very user friendly way to avoid getting sick.

I recently returned from a trip overseas and had concerns about being in airplanes and airports, knowing that the odds of my catching a bug were increased by being exposed to so many people in an enclosed environment. Every time someone coughed on the plane I thought to myself “keep your hands off your face, keep your hands off your face,” reciting it to myself like some kind of magical mantra that would protect me. Although I felt badly for the young child coughing non-stop a few rows up from me on the airbus, I equally worried that somehow the germs would float back to me in the recycled air of the plane.

Somehow I managed to make the long journey in both directions and come home with my body flu-free. Lucky me, I figured now I could relax. Then the inevitable happened-……read more (more…)

One womans journey and a whole lot of help for those who have pelvic organ prolapse

Helping raise the awareness of pelvic organ prolapse will help educate those who need to know what to do when they do find ‘bits falling outside of their bodies’.

Thousands of women are either too ashamed or simply don’t know what is happening to them. Pelvic organ prolapse happens for many reasons and over 50% of women experience this especially after giving birth.

One of the most common feelings is that you feel you are sitting on a tennis ball.

There are methods to help and prevent pelvic organ prolapse and with your help of passing this message along we can help those who need it.

Mothers, speak to your daughters (not always an easy subject) about it if you have experienced pelvic floor dysfunction. Chances are that if you have it so will your daughters.

Sherrie Palm, founder of APOPS (Association for pelvic organ pro. lapse support) has been fighting to bring this subject to the forefont of the medical staff who can help these women.

Pessaries have been around hundreds of years to treat symptoms as a treatment for menstrual problems, dysmenorrhea, incompetent cervix, infertility, uterovaginal prolapse and displacement of the uterus and treatment of women who showed symptoms of a pelvic organ prolapse has been around for thousands of years.

The earliest text found to be on obstetrics and gynaecology is that of Soranus of Ephesus a Greek physician (A.D. 98-138), which can be found in the ‘Bibliothèque Royale’ in Paris. Soranus had observed and reviewed a number of techniques used for management of uterovaginal prolapse during the Hippocratic era.

Soranus challenged and criticized treatments involving suspending the patient upside down by her feet from a moving frame which moved rapidly up and down for a few minutes, which was said to reduce the prolapse. The woman was then left to hang upside down for up to a day.

He also criticized the practise of his peers when they used ox meat inserted into the vagina and also those who used the method of a ‘hairy bag to the uterus, so that the sharp pains to the uterus caused from the hair caused the uterus to contract.

Pleasant aromas where used for patients to smell so as to disguise the unpleasant pungent odour of the ‘fumigation procedure to the uterus’ surgeons carried out. Their reasoning behind this method was that they believed the uterus would revoke the bad odours and move up in the direction towards the pleasant ones. Soranus condemned these treatments as harmful, painful and mostly ineffective.

Soranus had his own ideas about the treatment of a uterine prolapse, a method which was less painful and later on the pessary for pelvic organ prolapse and lubricant was to be innovated from this method.

He made the patient bathe the uterus in luke warm olive oil then corresponding to the shape and the diameter he would make a woollen tampon wrapped in very thin linen. He then dipped the tampon in diluted vinegar or the juice of acacia mixed with wine and applied this to the uterus whilst moving the uterus very gently upwards towards its natural anatomical state. To ensure the uterus stayed in position he wadded the whole vaginal cavity with wool. After this the woman’s legs were bandaged together where she remained on rest for 3 days. After 3 days the ‘pessary of wool and linen were removed.

Today’s methods have evolved still using pessaries as a non – surgical support mechanism for various types of pelvic organ prolapse conditions. There are many pessary shapes and sizes available, the most common used today are the ring and Gellhorn pessaries.

Pessaries are made from either PVC or silicone. Silicone being the favoured choice as it is flexible yet strong enough to support the prolapse and silicone is an inert material which reduces the chance of infection drastically.

There are various surgical procedures to correct pelvic organ prolapse conditions and the DaVinci Robot is one of the least invasive procedures for surgery to date.

Who knows, that maybe in another 100 years from now we will find the use of today’s pessaries and surgical procedures barbaric and unthinkable, but until we find the perfect solution to help women who suffer pelvic organ prolapse we just have to keep educating and raising the awareness that there are solutions out there for pelvic organ prolapses.

If you are reading this you are not my audience. Sorry. The fact that you are reading something to do with incontinence suggests that you already have an understanding about the condition, are comfortable getting information about it, and are keen to learn more. So, you either are, or, will be, alright.

The people I fret about are the millions of women who are living with their leaking and not yet seeking help. They just put up with having poor bladder control, pad up, and feel a bit disappointed.

Well, I say “feel a bit disappointed”. In fact is that a third of them go on to develop clinical depression. Of course, exercise is commonly recommended for managing mood disorders – but, if you leak when you run, well, you’re not going to go for a run, are you?

And, therein lies the huge public health rub.

Diseases of inactivity, like coronary heart disease, kill women. One in eight UK women die from heart disease. Exercise isn’t just about being able to keep up with the kids, or beating the blue, it’ll keep us alive.

But, speaking as someone who peed herself during zumba…it is very difficult to be physically active and avoid impact on your pelvic floor.

When I rule the world, some pieces of gym equipment will carry “pelvic floor warning” signs. Rowing machines, reclining bikes, a loaded leg press – yep, wouldn’t want anyone with a prolapse on those things. Oh, or trampolines, those things can have a label on them. And, the plank, star jumps, tennis, lunges, I could go on.

In fact, I’d force incontinence pad manufacturers to print pelvic health advice on their packaging. And, while we’re at it, they can fix that awful glue which comes unstuck and allows the pad to attach itself to your labia instead of your gusset…ouch.

So, we’ve got a classic Catch 22. In order to reduce your risk of pelvic organ prolapse and your symptoms of stress incontinence you need to keep your weight under control. But, you wet yourself at zumba, so aren’t keen…

However, runners? They wanna run, not walk, they want to run. That’s when internal support can be helpful, Sherrie Palm (she knows everything there is to know about pelvic floors) says that pessaries like incostress should be used when a woman is participating in acvities with impact.

Now, that does not mean that you can shove in a grade 4 prolapse with an incostress and get back to athletics training…but, it does mean that if you have a mild prolapse, or mild stress incontinence symptoms, and you are complying with a pelvic floor strengthening regime which your physiotherapist has given you, AND you use internal support – well, you just might manage to get back to zumba.

Ask me how I know.

Credited to Elaine Miller

Elaine Miller on of the UKs leading physiotherapists who has a post-grad in sports medicine. She focuses her energy on helping women overcome pelvic floor disorders and incontinence and breaks down the taboo through her humour and pelvic floor parties where she has a one hour solo show entitled ‘Gusset Grippers’. Look out for Gusset Grippers at Edinburgh Fringe Festival this August. An amazing lady who fears no pelvic floor!

Pelvic Organ Prolapse the silent epidemic by Sherrie Palm
An award winning fantastic book which gives women down to earh plain speaking advice, diagnosis and how to deal with Pelvic organ prolapse.

Pelvic organ prolapse is an extremely common female health issue that ALL WOMEN need to know about. Symptoms of pelvic organ prolapse (POP) can be confused and mistaken for other health conditions. Symptoms of POP are:

Vaginal childbirth and menopause are the two leading causes of POP. Unfortunately, most women first hear about pelvic organ prolapse AFTER they are diagnosed with POP.

If you suffer from any of the above symptoms, you may be suffering from a cystocele, rectocele, or type of POP and should talk with your physician about pelvic organ prolapse now.

Our goal is to increase awareness and recognition of POP symptoms, causes, and treatments. Pelvic organ prolapse impacts millions of women around the world physically, emotionally, socially, sexually, and financially. We need to increase POP awareness; we need to increase it now.